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17603 POST THIS CARD NEAR FRONT OF BUILDING DmBER -- CITY 'OF ,WFIERTINO: Rmlr 1 UMBER 603 INSPECTION DIVISION JOB INSPECTION,RECORD / 7 /�,p / .a PERMIT EXPIRATION' - JOB ADDRESS 2_,-1 uV B", - U N I T# _LOT# , �+ L N p �" � m II ,PERMIT EXPIRES IF WORK^,1 OWNER D 1 '` CONTRACTOR �µ P KIS . ` IPC ISNOT STARTED WITHIN-, INSPECTION DATE INSPECTOR INSPECTION RECORD IBD DAYSOF PERMITISSU - .. FOUNDATION -- ANCE OR 180 DAYS FROM NOTE: LAST CALLED INSPECTION-i LIFER, ALL GRADING AND DRAINAGE SHALL BE INSTALLED PREGUNITE' _ TO COMPLY WITH THE APPROVED PLANS AND CITY OF ; ' PERMIT VAUDATON CUPERTINO STANDARDS. PMO GARAGE SLABS i r l_ POUR NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED Yii 1989 UNDERGROUND /SLAB r ,. PLUMBING ., . . ..�� V'. �1 ,4�G' / j. ELECTRICALW f ISSUANCE DATE MECHANICAL BLDG. ELECT, I PLG. MECH. DO NOT POURTLOOR UNTIL ABOVE HAS BEEN SIGNED BUILDING PERMIT WOOD FLOOR - -INFORMATION VALUATION SIFT. PLUMBING MECHANICAL yIJ: iU^v`O' r ELECTRICAL PERmIr rO FRAMINGP,G INSULATION- - STORIES TYPE CONSTR_ • OCC.GROUP . 'RES UNITS PLACE NO SUBFLOOR UNTIL ABOVE HAS BEEN SIGNED Ep.FT FLOOR AREA TOTAL ACREAGE ROOF NOTE:NO FINAL INSP.SHALL BE MADE BEFORE , • DIAPHRAGM THE CONSTRUCTION_TAX IS PAID BUILDING USE ROOFSHEATHING RES IND CON PB .ouL., APPLY NO ROOFING UNTIL ABOVE HAS BEEN SIGNED FINALS DATE INSP. 1:1C] Assessoas PARCEL NO ROUGH SAN.# . PLUMBING ELECT.ENERGY TRACT NO, PARCEL NO TUBS&SHOWER PAN PLUMBING ENERGY _ MECHANICAL MECH.ENERGY ' ACC.DATE ACC.FILE NO. ELECTRICAL, BUILDING ENERGY FRAMINGELECT.FINAL TEST ZONING ENG,SITE NO. INSULATION - PLUMBING GAS TEST • GAS ' MECHANICAL FIRE SPRINrc - EN EAGY T.24 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED HEATING ' [:] "[], EXTERIOR SHEAR ELECTRICAL RELEASE FLOODZONE ALUG INTERIOR SHEAR - FI RE DEPT. Y ❑ N❑ Y.L7 NQ' SHEETROCK - GRADE FEE SUMMARY EXTERIOR LATH BUILDING ({ INTERIOR LATH - TEMPORARY APPROVALSV BUILDING - 6.2.'Oe SCRATCH COAT - ELECTRIC PLAN CHECK GAS FEE NO TAPE OR PLASTER UNTIL ABOVE HAS BEEN SIGNED OCCUPANCY - SEISMIC FEE a,Z, • OCCUPANCY OF BUI LDING IS NOT PERMITTED UNTIL BUILDING FINAL IS SIGNED By BUILDING INSPECTOR. MICROFILM ARRANGE FOR INSPECTION BY PHONING 252-4505, ELECTRIC H� ONE WORKING DAY BEFORE REQUIRED INSPECTION. PLUMBING 0 PLEASE GIVE JOB� ADDRESS WHEN PHONING.. ? - SEE PERMIT FOR EXPIRATION DATE - MECHANICAL Jr�f1 IMPORTANT! CONST.TAX READ R OI,p a PLEASE READ REVERSE SIDE BEFORE t . TOTAL . �( ;Z� CALLING FOR FINAL INSPECTION; OFFICE COPY APPLICANT TO FILL IN INFORMATION WITHIN RED LINES - USE BALL POINT PEN ONLY BUILDING PROJECT IDENTIFICATION - PERMIT NUMBER aUjamNG : rAPPLICATION & PERMIT ADDRESS 12 II 17.603 BUILDING - ELECTRICAL-PLUMBING-MECHANICAL OWNER'S NAME PLAN CHECK VA .16ATION ,x (y I DTV, ELECTRIC PERMIT FEE �✓/f [J /A o rcaC 's PRONE Is-p7ob s ( (2q CONTRACTOR'S NAME; I JOUTLETS-SWITCHES-RECEP 10.00/1.00 ' (SAID COMMERL A MoNAN)LN ,7 t) 3 3e LIGHTING FIXTURES 10.00/1.00 CONTRACTOR s �/S7 EWAPPLIANCES-RESIDENTIAL 4.00ao2s /0eZ5IANDRo1„DNE43Ii929Oo PANELS 10.00 DATE OF APPLICATION M ARCHITECT - PLAN CHECK FEE P.C.NO. OR - PANELS (OVER 200 AMP) 20.00 ENGINEER LIC.NO. SIGNS TRANS. 3.00 ARCH.OR ENG. PERMIT VALIDATION ADDRESS SPECIAL CIRCUIT '5,00r ,-„ ZIP TEMP.METER OR POLE INS. 20.00 APPLICANTS AMOTORS SEE FEE SCH. ' ooREss 1029 3R Zsl wn Rl:,#aj ew SERVICE CHANGE PAID 20.00 _ I V�14 C_C t woo LICENSED CONTRACTORS DECLARATION V F U w I hereby affirm that 1 am,licensed under provisions of Chapter 9 1( ISSUANCE DAT ' (commencing wi]I Section 7000)'of Division 3 a.the Business and w 3 vii - BLDG. ELECT. PLG. MECH. t- 0 2 Professions Code and my license is in full force and effect hyWD z O m- License Class Lic.Number City. p,,.s�.�.. O v, � D Data -moi �Comrador y �. - Y F , BUILDING PERMIT rc O CC U OWNER-BUILDER DECLARATION - INFORMATION X ; LL I hereby at that I am exempt from the Contractor's License MISC.- REFER TO ORD w VALUATION r Law for nycit following county o pax.c. Business and Professions PERMIT ISSUANCE 10.00 I /� Code:Anycityrnu nlywhiny structure, prior ttocon,vaam ,ahsalter, a ¢ ¢ 0 improve,he applicant repair any structure,prior to its issuance,also EHEC.CONTR. LIC.N0. ELEC. ` o u requires the applicant Co[such permit to filo a signed statement that TOTAL n w m he I5 licensed pursuant to the provisions of the Contractor's License PERMIT TO H z i Law(Chapter 9(Commencing with Section 7000)of Division 3 oflhe ,/lA S 4 o Business and Professions Code)or that he is exempt therefrom and DTV. . PLUMBING PERMIT FEE - lJ-� M I-m the basis for the alleged exemption.Any violation of Section 7031.5 STORIES TYPE CONSTR. a3 by any applicaut for a permit subjects the applicant to a civil penalty ALTER-DRAIN 5.00 of not more than five Hundred dollars($500).): , Cl I,as owner of the property,or my employees with wages as BACK FLOW PROTECT.DEVICE 4.00 OCC.GROUP RES.UNITS their sole compensation,will do the work,and the structure is not intended or Offered for sale (Sec. 7044, Business and Professions DRAINS-FLOOR,ROOF,AREA,COND. 5.00 Code:The Contractor's License Law does not apply to an owner of property who builds or improves[hereon,and who does such work FIXTURES,PER TRAP .5.00 SO.FT.FLOOR AREA TOTAL ACREAGE himself or through his own employees,provided that such improve- mentsamnotintendedorofferedforsale..If,however,the building GAS-EA.SYSTEM-11NC.40UTLETS 6.00 or improvement is sold within one year of completion,the owner- GAS-EASYSTEM-OVER 4 (EA) 200 BUILDING USE builder will have the burden of proving that he did not build or im- . . . RES IND CON PB ' Other prove for purpose of sale.). INDUSTRIAL WASTE INTER. 30.00 ❑ I,as owner of the property,am exclusively contracting with ❑ ❑ ❑ ❑ ❑ licensed contractors to construct the project(Sc,. 7044,Business LAWN SPRINKLERS-1'INC 5 V.B. 6.00 ASSESSORS PARCEL NO. and Professions Code:The Contractor's License Law does not apply to an owner of property who builds or improves thereon,and who LAWN SPRINKLERS-OVER 5(EA.) 1.00 contracts for such projects with a contractor(s)licensed pursuant to SEWER-SANITARY-STORM EA.200ftI10.00 the Contractor's License Law. TRACT NO. PARCEL NO. ❑ l em exempt under Sec.-,B.&P.C.for this reason WATER HEATER W/VENT 6,00 - -� Owner - Date - 1 - WATER SYSTEM'. 5.00 ACC.OATE ACC.FILE NO. WORK F.RS'COMPENSATION DECLARATION WATER TREATING EQUIP. 5.00 .. I hereby affirm that I have a certificate ofconsent to sell'-insure, ZONING ENG.SITE NO. or a certificate of Workers'Compensation Insurance,or a certified copy Cher ffSec.3800,Lab.C.) �.r� t POIicY No.CW"e 11Company-Rke9& C=NDOM A'I 1 ( C" O ;1( Certified copy is hereby furnished. FIRE SPRINK •ENERGY T-24 Z ❑ Certified opy is fol Cath t e i[y i tion division. - r O Applicunt�� MISC.- REFER TO ORD. y❑ N❑ Y:❑ IN Cr W CERTIFICATE.OF EXEMPTION FROM WORKERS' PERMIT ISSUANCE 10,00 FLOOD ZONE A.L.U.C. LU > COMPENSATION INSURANCE PLG.CONTR. - LIC:NO. PLG. ❑ N❑ v [D •NO CL 0 (This section need not be completed if the permit is ]or one 'TOTAL hundred dollars(S 100)or less.) U O 1 certify that in the performance of the work for which this per: QTY. MECHANICAL PERMIT FEE FEE SUMMARY LL I. mit is issued,1 shall not employ any person in any manner so as to O W become subject to the Workers'Compensation Laws of California. BUILDING y . Date Applicant DD TO MECH. 'YaZ } W NOTICE TO APPLICANT'. If,after making this Certificate of Ex- ALTER OR A 5.00 D Z emption,you should become subject to the Workers Compensation 'APPLIANCE 5.00 PLAN CHECK provisions of the Labor Code, you must forthwith comply with FEE V such provisions or this permit shall be deemed revoked AIR HANDLING UNIT(TO 1Q000C.F.M.) 4.00 CONSTRUCTION LENDING AGENCY AIR HANDLING UNIT(OVER 10PMC.RM.) 6.00 - SEISMIC,FEE' 1 hereby affirm that there is a Construction lending agency for EXHAUST HOOD(WITH DUCT) 5.00 the performance of the work for which this permit is issued(Sec. MICROFILM 3097,Cie.CJ. HEATING UNIT(TO 100,000 B.T.U.) 8.00 ' Lender's Name Lender's Address HEATING UN IT(OVER 100,000 B.T.U.)9.50 ELECTRIC. '. 1 certify that I have read this application and slate that the above VENTILATION FAN (SINGLE) . 4.00 information is correct. I agree to comply with all city and county PLUMBING ordinances and state laws [elating to building construction, and BOILER-COMPI3 H.P.or 100,000 B.T.U.) 6.00 hereby authorize representatives of this city to enter upon the BOILER-COMP IOaar 100,000 BTU)SEE FEESCH. MECHANICAL above-mentioned property for inspection purposes. lx D D' (We) agree to Save, indemnify and keep harmless the City of MISC,- REFER TO ORD. [ Cupertino-against liabilities,judgments, Costs and expenses which - PERMIT ISSUANCE 10.00 I.L. CONST.TAX may in anyway accrue against sand Ci y in consequence of the rantt g/o/f�this��/(miIt MECH.CONT. LIC.NO. MECH. - /OL•aOH1 �,� �TIZ`Yp - TOTAL�1. UU TOTAL ' 2 • agnalu[e of 7ofApp pphcant on proctor Dale - OFFICE'COPtl